What causes restlessness and agitation?

If the person you’re caring for is feeling restless and agitated you could find it really challenging to cope with. But there’s often a reason for this behaviour. Find out what could be causing it…

What are the causes of restlessness?

Restless behaviour can take different forms, including fidgeting, pacing, agitation and sundowning. When you think about it, it’s not surprising; if you’ve spent your whole life doing certain activities (such as working, travelling, looking after children etc) then find you can’t do them anymore, you’re bound to become restless!

Other reasons for restlessness can include:

- Communication problems – they might be trying to tell you something but the dementia has made talking difficult.
- Anxiety – they may feel unsafe or unsure about a certain situation
- Boredom – if they’ve not got much to do all day, they could end up getting bored and restless.
- Hunger, thirst or needing the toilet – they’ve got a basic need such as this, it’s no wonder they’ll be feeling restless and trying to sort it out
- Pain, discomfort or a medical problem – joint pain, toothache, constipation or a urinary tract infection (UTI).

What can you do about restlessness?

Depending on the form or symptoms of restlessness, it can be very difficult and tiring for carers. If the restlessness is appearing mainly at the end of the day as sundowning, it can be tough after a long day. If the restlessness is actually occurring in the middle of the night, and waking everyone up, it can be absolutely exhausting.

If you’re struggling, try some of these…

Get a health check-up

If the restlessness is being caused by an underlying health problem, this should be picked up by a doctor, so organise a trip to the GP for a check-up.

Ensure regular meal times

Someone with dementia may forget to eat or drink, so if you think their restlessness is being caused by hunger or thirst, make sure they have easy access to food or drink, and remind them to make use of them. You may need to set up a mechanical reminder if they struggle to remember.

Set up a daily routine

It’s a good idea to put a daily care plan in place for someone with dementia. Providing structure to their day will ensure they know what to expect and when that might be.

Provide activities

As part of the daily care plan, make sure you include different hobbies and activities to keep the person you’re caring for stimulated and engaged. It could be listening to old music, playing a board game, doing some gardening or even daily chores such as housework.

Get out and about

Burning off excess energy will help to reduce the risk of restlessness – whether that’s a daily walk or even seated exercises.

Check for continence issues

Whether or not they use incontinence products, it’s worth checking if they need to have pads changed or just use the toilet.

Occupy their hands

If the restlessness takes the form of fidgety hands, giving them something to keep their hands busy could help. Soft toys and dolls are popular, but you can also buy soft ‘fiddle muff’ that have zips and ties to play with, a ‘rummage box’ full of buttons or other items which they can sort or handle.

Remember, if the restlessness is taking the form of wandering, sundowning or sleep problems, there’s also plenty you can do.